Refer your patient

Orthodontics

Write up pending

Referral Form
Select Practice*
Please select which dental practice you wish to refer to
Appointment date request*
Please select a preferred time slot for this patient
Patient Details
Please provide the details of the patient you wish to refer
Patient Name*
Please give us your patients full name
Patient Date of Birth*
Patient Email*
Patient Telephone Number*
Dentist Details
Please provide the details of the referring dentist.
Referring Practice Name*
Dentist Name*
Referrer Email*
Referral Details
Please provide details of the referral you wish to make.
Would you like us to carry out the definitive restoration at Sandstone?*
Would you like us to place a direct core (& post if appropriate) prior to returning the patient back to your practice?*
Teeth Chart*
Please indicate which teeth the referral concerns.
X-rays
Maximum file size: 16 MB
Please upload your patients x-rays if required

Available at these Practices

Sunlight Dental Practice

Table of Contents

Referral Process

  • Please include as much relevant information as possible on the referral form
  •  Attach any radiographs or clinical images that may assist in the triage process
  •  Ensure the patient is aware that this is a private referral
  • Once the referral has been submitted acopy of the referral form will be e mailed to the e mail address provided on the referral form
  • The patient’s details will be added to our system
  • Both you and the patient will receive confirmation that the referral has been received

Next Steps

  • The patient will be contacted once the referral has been triaged.
  •  Once the appointment is scheduled, we will notify you with the clinician’s name and the appointment date.
  • If we are unable to contact the patient or they decline the appointment, we will inform you and discharge the patient back to your care
  • Following the consultation, we will provide you with a summary, if appropriate.

Completion of treatment

  • Once treatment is complete, a final letter will be sent to you – our aim is to do this within 10 days of the patient’s final appointment.
  • All patients will be discharged back to your practice after completing treatment. Occasionally, patients request to remain under our care. Please note, it is not our policy to continue seeing referred patients and we will always discuss any such requests with you before proceeding.
Starting from £80

Related services

Patient Referral Form